OBJECTIVE: SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood. METHODS: This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment. RESULTS: In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride. CONCLUSION: To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.
Aged ; Anxiety ; Anxiety Disorders ; Blood Pressure ; Cholesterol ; Cholesterol, LDL ; Citalopram ; Comorbidity ; Drug Interactions ; Fasting ; Female ; Fluoxetine ; Glucose ; Humans ; Paroxetine ; Prospective Studies ; Risk Factors ; Sertraline ; Waist Circumference ; Weight Gain

Objective: Substance use has such effects on pupil diameter. Although there is knowledge about the acute effects of substances on pupils, studies showing their chronic effects are limited. The aim of the present study was to evaluate the effect of long-term substance use on scotopic, mesopic, and photopic vision. Methods: The present study with cross-sectional desgn was conducted at the Adiyaman Training and Research Hospital for Psychiatry in Adiyaman. This study involved 110 substance use disorder (SUD) patients and 46 healthy volunteers as the control. The parameters were measured and recorded automatically by a device. Results: The mean age was 23.44±5.53 years in the SUD group and 24.26±5.38 years in healthy controls (p=0.420). The mean age of onset of the substance was 17.74±3.89 years and the mean duration of substance use was 3.54±2.9 years. It was determined that the patients had not used any substance for a mean of 121.73±117.49 days. There was no significant difference between patient and control groups in terms of scotopic and mesopic measurements of both eyes (p>0.05). Photopic measurements were significantly higher in the patient group than in the control group (p<0.05). Photopic measurements were significantly higher in the opioid, cannabis, ecstasy, and multiple substance use groups than in the control group (p<0.05). Conclusion The most important topic of this study is that photopic vision is permanently impaired in patients with a history of chronic substance use. This was attributed to disrupted sympathetic-parasympathetic hierarchy.